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Financial Operations Recovery Specialist I-III: Any Anthem Office Location or Remote (PS33348)Location: United StatesNewRequisition #: PS33348Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join usand together we will drive the future of health care.This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.Financial Operations Recovery Specialist I-III:Responsible for setting up and adjusting claims over payments that have been previously identified. May do all or some of the following in relation to cash receipts, cash application, claim audits, collections, over payment vendor validation, and claim adjustments. Manager will determine job level based a upon the selected applicant’s skill-set relative to the qualifications.Primary duties may include, but are not limited to:
Reviews and validates paid claims for over payments using various techniques including system-based queries, specialized reporting, or other research.
Determines and calculates amount of over payments and processes refunds.
Researches voluntary refunds for accuracy.
Requires accurate balancing of all accounts.
Responsible for more routine issues.
May work with internal staff from other departments to ensure customer satisfaction.
May perform collection activities to ensure the recovery of over payments and maintenance of unprocessed cash and accounts receivable balances and all other cash applications.
Requires a H.S. diploma; 1-2 years of claims processing and/or customer service experience; or any combination of education and experience, which would provide an equivalent background.
Associate degree preferred.
1 year minimum of WGS claims processing experience required.
Current working knowledge using WGS required.
WGS professional and facility claims processing/adjustment experience is required.
Pricing system knowledge with WGS Stand Alone, ETS Networx Pricer/GA Pricing System, Price N Ship/ Central Networx Pricing, OHAS preferred.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visitus at antheminc.com/careers. EOE. M/F/Disability/Veteran.
Vacancy expired!